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Nathan104

Initially Approved But Now At Quality Review Board?

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I talked to the lady who had been working my initial claim for SSD and she told me a decision had been made. She told me that my claim was approved and I had an effective dat of Nov 05, but it had been picked up by the Quality Review board. It has been with this review board for going on 3 weeks now. She tol me that a certain percentage of cases get picked up for the review board and mine was just one of the picks.

My question is, if my claim was processed and initially approved, what are the chances of that being overturned and it denied? Is it common for this to happen with this review board thing? Im also worried about them changing the effective date as the Nov 05 is the earliest possible date I could have received and is actually 6 months before I even applied for SSD.

Im just paranoid since it is taking so long. Anyone have any experience or heard anything about the review board situation? Thanks.

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Nathan:

Same thing happened to me. I found out later that it really does not have all that much to do with your claim its more of how the person who approved at SSD works. Unless they made a glaring error you are still approved.

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Pete, thanks for the reply. Definitly makes me feel better.

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Pete, thanks for the reply. Definitly makes me feel better.

I agree that you probably don't have anything to worry about. There is a pretty big percentage that are tagged for quality review and very few are ever overturned. And by the way, the review usually takes about 3 weeks so you should hear this week. Now taking bets!!!!

Steve

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My SSA claim went thru the QRB, and I'm told the process is just to make sure that the i's are dotted and the T's are crossed. Once a doctor has stated "creditable" in the medical review, things go fairly fast thru the process. You are lucky in that they decided to award previous to your claim (as the law allows). In my case, they obviously picked a date that allows them to avoid paying retro pay. I had to ask for reconsideration, citing the medical evidence that the doctor said was creditable, and re-request the original date that I had applied for. I have no idea when this process will complete. I'm told that it may take up to three years. At issue is up to about 20k. It would take something really unusual to deny your claim at this point. I got two letters from the SSA during the initial claim process. The first stated that the medical requirements had been met, and the other eligibility criteria were being verified. The second was the award notice. The reason I went thru the SSA disability process was simply that I'm 62, and the additional $508 above what I would have received with SSA "early" retirement is a significant amount of money. Not to mention that the SSA disability medical review cites the very conditions that I'm either currently SC'd for, or have applied for SC for. I also obtained a full copy of my SSA file on CD, (FOIA) and noticed that the award letter in the file did not have a prepaired date, where the actual letter I received did. There were two pages (filled out forms) that were appropriate to send to the VA in support of my current claim. Both together were the SSA equivilent of an IMO based upon medical record review by a currently licensed doctor. The VA will have a hard time trying to discount the information and opinion stated on the forms.

I talked to the lady who had been working my initial claim for SSD and she told me a decision had been made. She told me that my claim was approved and I had an effective dat of Nov 05, but it had been picked up by the Quality Review board. It has been with this review board for going on 3 weeks now. She tol me that a certain percentage of cases get picked up for the review board and mine was just one of the picks.

My question is, if my claim was processed and initially approved, what are the chances of that being overturned and it denied? Is it common for this to happen with this review board thing? Im also worried about them changing the effective date as the Nov 05 is the earliest possible date I could have received and is actually 6 months before I even applied for SSD.

Im just paranoid since it is taking so long. Anyone have any experience or heard anything about the review board situation? Thanks.

Edited by Chuck75

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